Coping behavior and risk and resilience stress factors in French regional emergency medicine unit workers: a cross-sectional survey.

The Emergency Department (ED) has the highest workload in a hospital, offering care to patients in their most acute state of illness, as well as comforting their families and tending to stressful situations of the physical and psychological areal. Method. A cross-sectional survey of 366 Emergency Unit staff members including medical doctors, medical residents, medical nurses and ward aids, was undergone. Study participants came from four periphery hospitals in the Moselle Department of Eastern France with similar workforce and daily patient loads statistics. The instruments used were the Perceived Stress Scale PSS-10 and the Brief COPE questionnaire. Conclusions. Perceived work overload and overall stress is strongly related to work hours and tend to have a stronger influence on doctors than on the nursing staff. Substance use is a common coping method for medical interns, consistent with prior research. The regular assessment of the ED staff perception of stress and stress related factors is essential to support organizational decisions in order to promote a better work environment and better patient care.

Effect of ZnSO4 upon gastric acid secretion and carbonic anhydrase.

Starting from the multiple role zinc holds in the enzymatic processes of the body and from some positive data concerning treatment with zinc sulphate in gastric ulcer, we have studied the effect of ZnSO4 on gastric acid secretion in duodenal ulcer patients, as well as that on purified and gastric mucosa carbonic anhydrase. Gastric secretory testing showed that zinc sulphate administered in doses of 60 ml/day (1% solution) for 10 days reduced basal acid secretion in duodenal ulcer patients by 57.7%. In vitro, concentrations of ZnSO4 ranging between 10(-6) and 10(-2)M, inhibit purified carbonic anhydrase activity in a dose-dependent manner, reaching maximum effect at 10(-2)M, when carbonic anhydrase activity dropped from 2060 +/- 65 IU to 660 +/- 85 IU. A similar dose-dependent inhibition was found with gastric mucosa carbonic anhydrase activity, where ZnSO4 at 10(-2)M reduces enzyme activity from its basal value of 1.58 +/- 0.36 EU/mg to 0.88 +/- 0.21 EU/mg. Besides this effect, zinc sulphate antagonized in vitro the activation of both purified and gastric mucosa carbonic anhydrase by histamine. In conclusion, the mechanism of antisecretory effect of ZnSO4 might well be the inhibition of the carbonic anhydrase in the gastric mucosa.

Activation of carbonic anhydrase by beta-adrenergic agonists and inhibition by beta-adrenergic blockers.

Knowing the in vitro and in vivo gastric secretory effects of beta-adrenergic agonists and antagonists, as well as the role of carbonic anhydrase in the gastric HCl production, we investigated the effect of some beta-adrenoceptor agonists (isoprenaline and orciprenaline) and antagonists (propranolol, timolol, atenolol, pindolol, acebutolol, metoprolol, exoxprenolol) on the purified, human red blood cell and gastric mucosa carbonic anhydrase. All the drugs were added to enzymatic preparations in a concentration range of 10(-7)-10(-3) M, the enzymatic activity being determined according to Maren's micro-method. Dose-response relationships were plotted for each drug. The activating effect of the beta-adrenergic agonists isoprenaline and orciprenaline on all the three species of carbonic anhydrase was dose-dependent, maximum effect being reached at 10(-3) M, when a highly significant (p less than 0.001) enzymatic activation was achieved. Beta-adrenergic blocking drugs decreased significantly the activity of carbonic anhydrase, thus, the activity of purified enzyme decreased with propranolol depending on the dose from 2140 +/- 68 to 1060 +/- 82 I.U. (p less than 0.001), that of red blood cell enzyme from 3340 +/- 280 to 1050 +/- 180 I.U. (p less than 0.001) and that of gastric mucosa enzyme from 2.1 +/- 0.2 to 1.1 +/- 0.1 E.U./mg bioptic sample. They also antagonized dose-dependently the activating effect of beta-adrenergic agonists on the enzyme. The results suggest that carbonic anhydrase might be one of the sites of beta-adrenoceptors, further studies using specific radioligands being necessary to elucidate whether these effects represent the interaction of these drugs with their specific receptor or if they are unspecific pharmacologic effects.

Effect of verapamil on purified bovine carbonic anhydrase. An in vitro study.

Relying on previous data which prove the activation of purified and gastric mucosa carbonic anhydrase by interaction of histamine with calcium ions, the present paper investigates the effect of verapamil, a specific antagonist of calcium transport, on purified bovine red cell carbonic anhydrase. In vitro determination of enzymatic activity according to Maren's micromethod showed that verapamil, in concentrations ranging from 10(-8)-10(-3) mol/l inhibits carbonic anhydrase basal activity in a dose-dependent manner. Thus, at 10(-3) mol/l verapamil concentration - representing its maximal effect - carbonic anhydrase basal activity drops from 2114 +/- 244 IU to 1100 +/- 86 IU (p less than 0.01). At this concentration, the drug antagonizes the activating effect of histamine: while maximum concentration (10(-2) mol/l) of histamine activates the enzyme from 2116 +/- 182 IU to 3979 +/- 411 IU the enzyme activity in the presence of verapamil changes in a non-significant way to 2162 +/- 148 IU (p less than 0.10). As calcium was omitted from the in vitro system, the mechanism described here is probably independent of ion transport inhibition. The physiologic importance of this effect for gastric secretion is to be further clarified.